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12.19 Resource NutritionIntake - Content

Orders and Observations Work GroupMaturity Level: 0 Trial UseSecurity Category: Patient Compartments: Encounter, Patient, Practitioner, RelatedPerson

A record of food or fluid that is being consumed by a patient. A NutritionIntake may indicate that the patient may be consuming the food or fluid now or has consumed the food or fluid in the past. The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician. A common scenario where this information is captured is during the history taking process during a patient visit or stay or through an app that tracks food or fluids consumed. The consumption information may come from sources such as the patient's memory, from a nutrition label, or from a clinician documenting observed intake.

This resource is a request resource from a FHIR workflow perspective - see Workflow. It is the intent of the Orders and Observation Workgroup to align this resource with the workflow pattern for request resources.

The NutritionOrder resource describes a request for oral diets (including general diets such as General Healthy diet, or therapeutic diets such as Consistent Carbohydrate, 2 gram Sodium, or Fluid Restricted), oral nutrition supplements (such as nutritionally complete pre-packed drinks), enteral nutrition (tube feedings) and infant formula which govern the distribution of food and nutritional products used to feed patients within an in-patient setting. It does not cover orders for parenteral (IV) nutrition which are typically filled by pharmacy. These nutrition orders are combined with information on a patient's food allergies and intolerances, and ethnic or cultural food preferences (e.g. Kosher or Vegetarian) to inform healthcare personnel about the type, texture, and/or quantity of foods that the patient should receive or consume.

Enteral orders are distinguished from supplements because they have some unique attributes and typically include administration information whereas oral nutritional supplements may simply be supplied (e.g. home health or outpatient settings). In a simple case, the requestor may designate type of product, product name and the route of administration along with free text instructions without a having to complete the additional structured details.

This resource is intended to be used by providers from a variety of specialties such as physicians, dietitian/nutritionists, or speech therapists. One provider may simply order a base element oral diet such as General Healthful diet. Another provider, based on scope of practice, may use other elements to communicate additional therapeutic needs or patient preferences. The optionality included gives an ordering provider the capability to write a simple order for an oral diet, nutritional supplement or formula with minimal requirements beyond that of specifying the diet, supplement or formula product, but also supports the ability to provide more detailed information that may be further augmented by a dietitian or nutrition specialist. For example, a physician may order a 2 g sodium diet. A speech therapist, based on the results of a swallowing evaluation, then orders a mechanically altered texture with nectar thick liquids.

The NutritionOrder resource is used for requesting oral diets, oral nutrition supplements and enteral feedings in an in-patient setting. The MedicationRequest resource should be used for requesting parenteral (IV) nutrition and prescribing dietary supplements such as vitamin or mineral supplements.

The Nutrition Order is a record of the request for the supply of a diet, oral supplement or enteral formulas for a patient. However, to initiate the request requires the use of the Task resource and its associated workflow with the Nutrition Order referenced from Task.basedOn, or by using the Nutrition Task resource in the context of a messaging or service workflow where the request is explicit or implicit.

This resource is referenced by itself.

This resource implements the Event pattern.

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. NutritionIntake TUDomainResourceRecord of food or fluid being taken by a patient
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierExternal identifier
... basedOn Σ0..*Reference(NutritionOrder | CarePlan | ServiceRequest)Fulfils plan, proposal or order
... partOf Σ0..*Reference(NutritionIntake | Procedure | Observation)Part of referenced event
... status ?!Σ1..1codeactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
Nutrition intake status codes (Required)
... statusReason 0..*CodeableConceptReason for current status
SNOMED CT Drug Therapy Status codes (Example)
... category Σ0..*CodeableConceptType of nutrition intake setting/reporting
Nutrition intake category codes (Preferred)
... consumedItem 1..*BackboneElementWhat food or fluid product or item was consumed
.... type Σ1..1CodeableConceptThe type of food or fluid product
.... nutritionProduct Σ1..1CodeableConceptCode that identifies the food or fluid product that was consumed
.... schedule 0..1TimingScheduled frequency of consumption
.... amount Σ0..1SimpleQuantityQuantity of the specified food
.... rate Σ0..1SimpleQuantityRate at which enteral feeding was administered
.... notConsumed 0..1booleanFlag to indicate if the food or fluid item was refused or otherwise not consumed
.... notConsumedReason 0..1CodeableConceptReason food or fluid was not consumed
... ingredientLabel 0..*BackboneElementTotal nutrient for the whole meal, product, serving
.... nutrient 1..1CodeableConceptTotal nutrient consumed
.... amount 1..1SimpleQuantityTotal amount of nutrient consumed
... subject Σ1..1Reference(Patient | Group)Who is/was consuming the food or fluid
... encounter Σ0..1Reference(Encounter)Encounter associated with NutritionIntake
... effective[x] Σ0..1The date/time or interval when the food or fluid is/was consumed
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... dateAsserted Σ0..1dateTimeWhen the consumption was asserted?
... informationSource 0..1Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)Person or organization that provided the information about the consumption of this food or fluid
... derivedFrom 0..*Reference(Any)Additional supporting information
... reasonCode 0..*CodeableConceptReason for why the food or fluid is /was consumed
... reasonReference 0..*Reference(Condition | Observation | DiagnosticReport)Condition or observation that supports why the food or fluid is /was consumed
... note 0..*AnnotationFurther information about the consumption

doco Documentation for this format

UML Diagram (Legend)

NutritionIntake (DomainResource)Identifiers associated with this Nutrition Intake that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to serveridentifier : Identifier [0..*]A plan, proposal or order that is fulfilled in whole or in part by this eventbasedOn : Reference [0..*] « NutritionOrder|CarePlan|ServiceRequest »A larger event of which this particular event is a component or steppartOf : Reference [0..*] « NutritionIntake|Procedure|Observation »A code representing the patient or other source's judgment about the state of the intake that this assertion is about. Generally, this will be active or completed (this element modifies the meaning of other elements)status : code [1..1] « A coded concept indicating the current status of a NutritionIntake. (Strength=Required)NutritionIntake Status ! »Captures the reason for the current state of the NutritionIntakestatusReason : CodeableConcept [0..*] « A coded concept indicating the reason for the status of the statement. (Strength=Example) SNOMEDCTDrugTherapyStatusCodes?? »Indicates where the food or fluid was consumed or prescribedcategory : CodeableConcept [0..*] « A coded concept identifying where the medication included in the NutritionIntake is expected to be consumed or administered. (Strength=Preferred)NutritionIntake Category ? »The person, animal or group who is/was consuming the food or fluidsubject : Reference [1..1] « Patient|Group »The encounter that establishes the context for this NutritionIntakeencounter : Reference [0..1] « Encounter »The interval of time during which it is being asserted that the patient is/was consuming the food or fluideffective[x] : Type [0..1] « dateTime|Period »The date when the Nutrition Intake was asserted by the information sourcedateAsserted : dateTime [0..1]The person or organization that provided the information about the consumption of this food or fluid. Note: Use derivedFrom when a NutritionIntake is derived from other resourcesinformationSource : Reference [0..1] « Patient|Practitioner| PractitionerRole|RelatedPerson|Organization »Allows linking the NutritionIntake to the underlying NutritionOrder, or to other information, such as AllergyIntolerance, that supports or is used to derive the NutritionIntakederivedFrom : Reference [0..*] « Any »A reason for why the food or fluid is /was consumedreasonCode : CodeableConcept [0..*]Condition or observation that supports why the food or fluid is /was consumedreasonReference : Reference [0..*] « Condition|Observation| DiagnosticReport »Provides extra information about the Nutrition Intake that is not conveyed by the other attributesnote : Annotation [0..*]ConsumedItemIndicates what a category of item that was consumed: eg., food, fluid, enteral, etctype : CodeableConcept [1..1]Identifies the food or fluid product that was consumed. This is potentially a link to a resource representing the details of the food product (TBD) or a simple attribute carrying a code that identifies the food from a known list of foodsnutritionProduct : CodeableConcept [1..1]Scheduled frequency of consumptionschedule : Timing [0..1]Quantity of the specified foodamount : Quantity(SimpleQuantity) [0..1]Rate at which enteral feeding was administeredrate : Quantity(SimpleQuantity) [0..1]Indicator when a patient is in a setting where it is helpful to know if food was not consumed, such as it was refused, held (as in tube feedings), or otherwise not provided. If a consumption is being recorded from an app, such as MyFitnessPal, this indicator will likely not be usednotConsumed : boolean [0..1]Document the reason the food or fluid was not consumed, such as refused, held, etcnotConsumedReason : CodeableConcept [0..1]IngredientLabelTotal nutrient consumed. This could be a macronutrient (protein, fat, carbohydrate), or a vitamin and mineralnutrient : CodeableConcept [1..1]Total amount of nutrient consumedamount : Quantity(SimpleQuantity) [1..1]What food or fluid product or item was consumedconsumedItem[1..*]Total nutrient amounts for the whole meal, product, serving, etcingredientLabel[0..*]

XML Template

<NutritionIntake xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External identifier --></identifier>
 <basedOn><!-- 0..* Reference(CarePlan|NutritionOrder|ServiceRequest) Fulfils plan, proposal or order --></basedOn>
 <partOf><!-- 0..* Reference(NutritionIntake|Observation|Procedure) Part of referenced event --></partOf>
 <status value="[code]"/><!-- 1..1 active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken -->
 <statusReason><!-- 0..* CodeableConcept Reason for current status --></statusReason>
 <category><!-- 0..* CodeableConcept Type of nutrition intake setting/reporting --></category>
 <consumedItem>  <!-- 1..* What food or fluid product or item was consumed -->
  <type><!-- 1..1 CodeableConcept The type of food or fluid product --></type>
  <nutritionProduct><!-- 1..1 CodeableConcept Code that identifies the food or fluid product that was consumed --></nutritionProduct>
  <schedule><!-- 0..1 Timing Scheduled frequency of consumption --></schedule>
  <amount><!-- 0..1 Quantity(SimpleQuantity) Quantity of the specified food --></amount>
  <rate><!-- 0..1 Quantity(SimpleQuantity) Rate at which enteral feeding was administered --></rate>
  <notConsumed value="[boolean]"/><!-- 0..1 Flag to indicate if the food or fluid item was refused or otherwise not consumed -->
  <notConsumedReason><!-- 0..1 CodeableConcept Reason food or fluid was not consumed --></notConsumedReason>
 </consumedItem>
 <ingredientLabel>  <!-- 0..* Total nutrient for the whole meal, product, serving -->
  <nutrient><!-- 1..1 CodeableConcept Total nutrient consumed --></nutrient>
  <amount><!-- 1..1 Quantity(SimpleQuantity) Total amount of nutrient consumed --></amount>
 </ingredientLabel>
 <subject><!-- 1..1 Reference(Group|Patient) Who is/was consuming the food or fluid --></subject>
 <encounter><!-- 0..1 Reference(Encounter) Encounter associated with NutritionIntake --></encounter>
 <effective[x]><!-- 0..1 dateTime|Period The date/time or interval when the food or fluid is/was consumed --></effective[x]>
 <dateAsserted value="[dateTime]"/><!-- 0..1 When the consumption was asserted? -->
 <informationSource><!-- 0..1 Reference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Person or organization that provided the information about the consumption of this food or fluid --></informationSource>
 <derivedFrom><!-- 0..* Reference(Any) Additional supporting information --></derivedFrom>
 <reasonCode><!-- 0..* CodeableConcept Reason for why the food or fluid is /was consumed --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|DiagnosticReport|Observation) Condition or observation that supports why the food or fluid is /was consumed --></reasonReference>
 <note><!-- 0..* Annotation Further information about the consumption --></note>
</NutritionIntake>

JSON Template

{doco
  "resourceType" : "NutritionIntake",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External identifier
  "basedOn" : [{ Reference(CarePlan|NutritionOrder|ServiceRequest) }], // Fulfils plan, proposal or order
  "partOf" : [{ Reference(NutritionIntake|Observation|Procedure) }], // Part of referenced event
  "status" : "<code>", // R!  active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
  "statusReason" : [{ CodeableConcept }], // Reason for current status
  "category" : [{ CodeableConcept }], // Type of nutrition intake setting/reporting
  "consumedItem" : [{ // R!  What food or fluid product or item was consumed
    "type" : { CodeableConcept }, // R!  The type of food or fluid product
    "nutritionProduct" : { CodeableConcept }, // R!  Code that identifies the food or fluid product that was consumed
    "schedule" : { Timing }, // Scheduled frequency of consumption
    "amount" : { Quantity(SimpleQuantity) }, // Quantity of the specified food
    "rate" : { Quantity(SimpleQuantity) }, // Rate at which enteral feeding was administered
    "notConsumed" : <boolean>, // Flag to indicate if the food or fluid item was refused or otherwise not consumed
    "notConsumedReason" : { CodeableConcept } // Reason food or fluid was not consumed
  }],
  "ingredientLabel" : [{ // Total nutrient for the whole meal, product, serving
    "nutrient" : { CodeableConcept }, // R!  Total nutrient consumed
    "amount" : { Quantity(SimpleQuantity) } // R!  Total amount of nutrient consumed
  }],
  "subject" : { Reference(Group|Patient) }, // R!  Who is/was consuming the food or fluid
  "encounter" : { Reference(Encounter) }, // Encounter associated with NutritionIntake
  // effective[x]: The date/time or interval when the food or fluid is/was consumed. One of these 2:
  "effectiveDateTime" : "<dateTime>",
  "effectivePeriod" : { Period },
  "dateAsserted" : "<dateTime>", // When the consumption was asserted?
  "informationSource" : { Reference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // Person or organization that provided the information about the consumption of this food or fluid
  "derivedFrom" : [{ Reference(Any) }], // Additional supporting information
  "reasonCode" : [{ CodeableConcept }], // Reason for why the food or fluid is /was consumed
  "reasonReference" : [{ Reference(Condition|DiagnosticReport|Observation) }], // Condition or observation that supports why the food or fluid is /was consumed
  "note" : [{ Annotation }] // Further information about the consumption
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:NutritionIntake;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:NutritionIntake.identifier [ Identifier ], ... ; # 0..* External identifier
  fhir:NutritionIntake.basedOn [ Reference(CarePlan|NutritionOrder|ServiceRequest) ], ... ; # 0..* Fulfils plan, proposal or order
  fhir:NutritionIntake.partOf [ Reference(NutritionIntake|Observation|Procedure) ], ... ; # 0..* Part of referenced event
  fhir:NutritionIntake.status [ code ]; # 1..1 active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
  fhir:NutritionIntake.statusReason [ CodeableConcept ], ... ; # 0..* Reason for current status
  fhir:NutritionIntake.category [ CodeableConcept ], ... ; # 0..* Type of nutrition intake setting/reporting
  fhir:NutritionIntake.consumedItem [ # 1..* What food or fluid product or item was consumed
    fhir:NutritionIntake.consumedItem.type [ CodeableConcept ]; # 1..1 The type of food or fluid product
    fhir:NutritionIntake.consumedItem.nutritionProduct [ CodeableConcept ]; # 1..1 Code that identifies the food or fluid product that was consumed
    fhir:NutritionIntake.consumedItem.schedule [ Timing ]; # 0..1 Scheduled frequency of consumption
    fhir:NutritionIntake.consumedItem.amount [ Quantity(SimpleQuantity) ]; # 0..1 Quantity of the specified food
    fhir:NutritionIntake.consumedItem.rate [ Quantity(SimpleQuantity) ]; # 0..1 Rate at which enteral feeding was administered
    fhir:NutritionIntake.consumedItem.notConsumed [ boolean ]; # 0..1 Flag to indicate if the food or fluid item was refused or otherwise not consumed
    fhir:NutritionIntake.consumedItem.notConsumedReason [ CodeableConcept ]; # 0..1 Reason food or fluid was not consumed
  ], ...;
  fhir:NutritionIntake.ingredientLabel [ # 0..* Total nutrient for the whole meal, product, serving
    fhir:NutritionIntake.ingredientLabel.nutrient [ CodeableConcept ]; # 1..1 Total nutrient consumed
    fhir:NutritionIntake.ingredientLabel.amount [ Quantity(SimpleQuantity) ]; # 1..1 Total amount of nutrient consumed
  ], ...;
  fhir:NutritionIntake.subject [ Reference(Group|Patient) ]; # 1..1 Who is/was consuming the food or fluid
  fhir:NutritionIntake.encounter [ Reference(Encounter) ]; # 0..1 Encounter associated with NutritionIntake
  # NutritionIntake.effective[x] : 0..1 The date/time or interval when the food or fluid is/was consumed. One of these 2
    fhir:NutritionIntake.effectiveDateTime [ dateTime ]
    fhir:NutritionIntake.effectivePeriod [ Period ]
  fhir:NutritionIntake.dateAsserted [ dateTime ]; # 0..1 When the consumption was asserted?
  fhir:NutritionIntake.informationSource [ Reference(Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Person or organization that provided the information about the consumption of this food or fluid
  fhir:NutritionIntake.derivedFrom [ Reference(Any) ], ... ; # 0..* Additional supporting information
  fhir:NutritionIntake.reasonCode [ CodeableConcept ], ... ; # 0..* Reason for why the food or fluid is /was consumed
  fhir:NutritionIntake.reasonReference [ Reference(Condition|DiagnosticReport|Observation) ], ... ; # 0..* Condition or observation that supports why the food or fluid is /was consumed
  fhir:NutritionIntake.note [ Annotation ], ... ; # 0..* Further information about the consumption
]

Changes since R3

This resource did not exist in Release 2

This analysis is available as XML or JSON.

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. NutritionIntake TUDomainResourceRecord of food or fluid being taken by a patient
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierExternal identifier
... basedOn Σ0..*Reference(NutritionOrder | CarePlan | ServiceRequest)Fulfils plan, proposal or order
... partOf Σ0..*Reference(NutritionIntake | Procedure | Observation)Part of referenced event
... status ?!Σ1..1codeactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
Nutrition intake status codes (Required)
... statusReason 0..*CodeableConceptReason for current status
SNOMED CT Drug Therapy Status codes (Example)
... category Σ0..*CodeableConceptType of nutrition intake setting/reporting
Nutrition intake category codes (Preferred)
... consumedItem 1..*BackboneElementWhat food or fluid product or item was consumed
.... type Σ1..1CodeableConceptThe type of food or fluid product
.... nutritionProduct Σ1..1CodeableConceptCode that identifies the food or fluid product that was consumed
.... schedule 0..1TimingScheduled frequency of consumption
.... amount Σ0..1SimpleQuantityQuantity of the specified food
.... rate Σ0..1SimpleQuantityRate at which enteral feeding was administered
.... notConsumed 0..1booleanFlag to indicate if the food or fluid item was refused or otherwise not consumed
.... notConsumedReason 0..1CodeableConceptReason food or fluid was not consumed
... ingredientLabel 0..*BackboneElementTotal nutrient for the whole meal, product, serving
.... nutrient 1..1CodeableConceptTotal nutrient consumed
.... amount 1..1SimpleQuantityTotal amount of nutrient consumed
... subject Σ1..1Reference(Patient | Group)Who is/was consuming the food or fluid
... encounter Σ0..1Reference(Encounter)Encounter associated with NutritionIntake
... effective[x] Σ0..1The date/time or interval when the food or fluid is/was consumed
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... dateAsserted Σ0..1dateTimeWhen the consumption was asserted?
... informationSource 0..1Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)Person or organization that provided the information about the consumption of this food or fluid
... derivedFrom 0..*Reference(Any)Additional supporting information
... reasonCode 0..*CodeableConceptReason for why the food or fluid is /was consumed
... reasonReference 0..*Reference(Condition | Observation | DiagnosticReport)Condition or observation that supports why the food or fluid is /was consumed
... note 0..*AnnotationFurther information about the consumption

doco Documentation for this format

UML Diagram (Legend)

NutritionIntake (DomainResource)Identifiers associated with this Nutrition Intake that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to serveridentifier : Identifier [0..*]A plan, proposal or order that is fulfilled in whole or in part by this eventbasedOn : Reference [0..*] « NutritionOrder|CarePlan|ServiceRequest »A larger event of which this particular event is a component or steppartOf : Reference [0..*] « NutritionIntake|Procedure|Observation »A code representing the patient or other source's judgment about the state of the intake that this assertion is about. Generally, this will be active or completed (this element modifies the meaning of other elements)status : code [1..1] « A coded concept indicating the current status of a NutritionIntake. (Strength=Required)NutritionIntake Status ! »Captures the reason for the current state of the NutritionIntakestatusReason : CodeableConcept [0..*] « A coded concept indicating the reason for the status of the statement. (Strength=Example) SNOMEDCTDrugTherapyStatusCodes?? »Indicates where the food or fluid was consumed or prescribedcategory : CodeableConcept [0..*] « A coded concept identifying where the medication included in the NutritionIntake is expected to be consumed or administered. (Strength=Preferred)NutritionIntake Category ? »The person, animal or group who is/was consuming the food or fluidsubject : Reference [1..1] « Patient|Group »The encounter that establishes the context for this NutritionIntakeencounter : Reference [0..1] « Encounter »The interval of time during which it is being asserted that the patient is/was consuming the food or fluideffective[x] : Type [0..1] « dateTime|Period »The date when the Nutrition Intake was asserted by the information sourcedateAsserted : dateTime [0..1]The person or organization that provided the information about the consumption of this food or fluid. Note: Use derivedFrom when a NutritionIntake is derived from other resourcesinformationSource : Reference [0..1] « Patient|Practitioner| PractitionerRole|RelatedPerson|Organization »Allows linking the NutritionIntake to the underlying NutritionOrder, or to other information, such as AllergyIntolerance, that supports or is used to derive the NutritionIntakederivedFrom : Reference [0..*] « Any »A reason for why the food or fluid is /was consumedreasonCode : CodeableConcept [0..*]Condition or observation that supports why the food or fluid is /was consumedreasonReference : Reference [0..*] « Condition|Observation| DiagnosticReport »Provides extra information about the Nutrition Intake that is not conveyed by the other attributesnote : Annotation [0..*]ConsumedItemIndicates what a category of item that was consumed: eg., food, fluid, enteral, etctype : CodeableConcept [1..1]Identifies the food or fluid product that was consumed. This is potentially a link to a resource representing the details of the food product (TBD) or a simple attribute carrying a code that identifies the food from a known list of foodsnutritionProduct : CodeableConcept [1..1]Scheduled frequency of consumptionschedule : Timing [0..1]Quantity of the specified foodamount : Quantity(SimpleQuantity) [0..1]Rate at which enteral feeding was administeredrate : Quantity(SimpleQuantity) [0..1]Indicator when a patient is in a setting where it is helpful to know if food was not consumed, such as it was refused, held (as in tube feedings), or otherwise not provided. If a consumption is being recorded from an app, such as MyFitnessPal, this indicator will likely not be usednotConsumed : boolean [0..1]Document the reason the food or fluid was not consumed, such as refused, held, etcnotConsumedReason : CodeableConcept [0..1]IngredientLabelTotal nutrient consumed. This could be a macronutrient (protein, fat, carbohydrate), or a vitamin and mineralnutrient : CodeableConcept [1..1]Total amount of nutrient consumedamount : Quantity(SimpleQuantity) [1..1]What food or fluid product or item was consumedconsumedItem[1..*]Total nutrient amounts for the whole meal, product, serving, etcingredientLabel[0..*]

XML Template

<NutritionIntake xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External identifier --></identifier>
 <basedOn><!-- 0..* Reference(CarePlan|NutritionOrder|ServiceRequest) Fulfils plan, proposal or order --></basedOn>
 <partOf><!-- 0..* Reference(NutritionIntake|Observation|Procedure) Part of referenced event --></partOf>
 <status value="[code]"/><!-- 1..1 active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken -->
 <statusReason><!-- 0..* CodeableConcept Reason for current status --></statusReason>
 <category><!-- 0..* CodeableConcept Type of nutrition intake setting/reporting --></category>
 <consumedItem>  <!-- 1..* What food or fluid product or item was consumed -->
  <type><!-- 1..1 CodeableConcept The type of food or fluid product --></type>
  <nutritionProduct><!-- 1..1 CodeableConcept Code that identifies the food or fluid product that was consumed --></nutritionProduct>
  <schedule><!-- 0..1 Timing Scheduled frequency of consumption --></schedule>
  <amount><!-- 0..1 Quantity(SimpleQuantity) Quantity of the specified food --></amount>
  <rate><!-- 0..1 Quantity(SimpleQuantity) Rate at which enteral feeding was administered --></rate>
  <notConsumed value="[boolean]"/><!-- 0..1 Flag to indicate if the food or fluid item was refused or otherwise not consumed -->
  <notConsumedReason><!-- 0..1 CodeableConcept Reason food or fluid was not consumed --></notConsumedReason>
 </consumedItem>
 <ingredientLabel>  <!-- 0..* Total nutrient for the whole meal, product, serving -->
  <nutrient><!-- 1..1 CodeableConcept Total nutrient consumed --></nutrient>
  <amount><!-- 1..1 Quantity(SimpleQuantity) Total amount of nutrient consumed --></amount>
 </ingredientLabel>
 <subject><!-- 1..1 Reference(Group|Patient) Who is/was consuming the food or fluid --></subject>
 <encounter><!-- 0..1 Reference(Encounter) Encounter associated with NutritionIntake --></encounter>
 <effective[x]><!-- 0..1 dateTime|Period The date/time or interval when the food or fluid is/was consumed --></effective[x]>
 <dateAsserted value="[dateTime]"/><!-- 0..1 When the consumption was asserted? -->
 <informationSource><!-- 0..1 Reference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Person or organization that provided the information about the consumption of this food or fluid --></informationSource>
 <derivedFrom><!-- 0..* Reference(Any) Additional supporting information --></derivedFrom>
 <reasonCode><!-- 0..* CodeableConcept Reason for why the food or fluid is /was consumed --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|DiagnosticReport|Observation) Condition or observation that supports why the food or fluid is /was consumed --></reasonReference>
 <note><!-- 0..* Annotation Further information about the consumption --></note>
</NutritionIntake>

JSON Template

{doco
  "resourceType" : "NutritionIntake",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External identifier
  "basedOn" : [{ Reference(CarePlan|NutritionOrder|ServiceRequest) }], // Fulfils plan, proposal or order
  "partOf" : [{ Reference(NutritionIntake|Observation|Procedure) }], // Part of referenced event
  "status" : "<code>", // R!  active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
  "statusReason" : [{ CodeableConcept }], // Reason for current status
  "category" : [{ CodeableConcept }], // Type of nutrition intake setting/reporting
  "consumedItem" : [{ // R!  What food or fluid product or item was consumed
    "type" : { CodeableConcept }, // R!  The type of food or fluid product
    "nutritionProduct" : { CodeableConcept }, // R!  Code that identifies the food or fluid product that was consumed
    "schedule" : { Timing }, // Scheduled frequency of consumption
    "amount" : { Quantity(SimpleQuantity) }, // Quantity of the specified food
    "rate" : { Quantity(SimpleQuantity) }, // Rate at which enteral feeding was administered
    "notConsumed" : <boolean>, // Flag to indicate if the food or fluid item was refused or otherwise not consumed
    "notConsumedReason" : { CodeableConcept } // Reason food or fluid was not consumed
  }],
  "ingredientLabel" : [{ // Total nutrient for the whole meal, product, serving
    "nutrient" : { CodeableConcept }, // R!  Total nutrient consumed
    "amount" : { Quantity(SimpleQuantity) } // R!  Total amount of nutrient consumed
  }],
  "subject" : { Reference(Group|Patient) }, // R!  Who is/was consuming the food or fluid
  "encounter" : { Reference(Encounter) }, // Encounter associated with NutritionIntake
  // effective[x]: The date/time or interval when the food or fluid is/was consumed. One of these 2:
  "effectiveDateTime" : "<dateTime>",
  "effectivePeriod" : { Period },
  "dateAsserted" : "<dateTime>", // When the consumption was asserted?
  "informationSource" : { Reference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // Person or organization that provided the information about the consumption of this food or fluid
  "derivedFrom" : [{ Reference(Any) }], // Additional supporting information
  "reasonCode" : [{ CodeableConcept }], // Reason for why the food or fluid is /was consumed
  "reasonReference" : [{ Reference(Condition|DiagnosticReport|Observation) }], // Condition or observation that supports why the food or fluid is /was consumed
  "note" : [{ Annotation }] // Further information about the consumption
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:NutritionIntake;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:NutritionIntake.identifier [ Identifier ], ... ; # 0..* External identifier
  fhir:NutritionIntake.basedOn [ Reference(CarePlan|NutritionOrder|ServiceRequest) ], ... ; # 0..* Fulfils plan, proposal or order
  fhir:NutritionIntake.partOf [ Reference(NutritionIntake|Observation|Procedure) ], ... ; # 0..* Part of referenced event
  fhir:NutritionIntake.status [ code ]; # 1..1 active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
  fhir:NutritionIntake.statusReason [ CodeableConcept ], ... ; # 0..* Reason for current status
  fhir:NutritionIntake.category [ CodeableConcept ], ... ; # 0..* Type of nutrition intake setting/reporting
  fhir:NutritionIntake.consumedItem [ # 1..* What food or fluid product or item was consumed
    fhir:NutritionIntake.consumedItem.type [ CodeableConcept ]; # 1..1 The type of food or fluid product
    fhir:NutritionIntake.consumedItem.nutritionProduct [ CodeableConcept ]; # 1..1 Code that identifies the food or fluid product that was consumed
    fhir:NutritionIntake.consumedItem.schedule [ Timing ]; # 0..1 Scheduled frequency of consumption
    fhir:NutritionIntake.consumedItem.amount [ Quantity(SimpleQuantity) ]; # 0..1 Quantity of the specified food
    fhir:NutritionIntake.consumedItem.rate [ Quantity(SimpleQuantity) ]; # 0..1 Rate at which enteral feeding was administered
    fhir:NutritionIntake.consumedItem.notConsumed [ boolean ]; # 0..1 Flag to indicate if the food or fluid item was refused or otherwise not consumed
    fhir:NutritionIntake.consumedItem.notConsumedReason [ CodeableConcept ]; # 0..1 Reason food or fluid was not consumed
  ], ...;
  fhir:NutritionIntake.ingredientLabel [ # 0..* Total nutrient for the whole meal, product, serving
    fhir:NutritionIntake.ingredientLabel.nutrient [ CodeableConcept ]; # 1..1 Total nutrient consumed
    fhir:NutritionIntake.ingredientLabel.amount [ Quantity(SimpleQuantity) ]; # 1..1 Total amount of nutrient consumed
  ], ...;
  fhir:NutritionIntake.subject [ Reference(Group|Patient) ]; # 1..1 Who is/was consuming the food or fluid
  fhir:NutritionIntake.encounter [ Reference(Encounter) ]; # 0..1 Encounter associated with NutritionIntake
  # NutritionIntake.effective[x] : 0..1 The date/time or interval when the food or fluid is/was consumed. One of these 2
    fhir:NutritionIntake.effectiveDateTime [ dateTime ]
    fhir:NutritionIntake.effectivePeriod [ Period ]
  fhir:NutritionIntake.dateAsserted [ dateTime ]; # 0..1 When the consumption was asserted?
  fhir:NutritionIntake.informationSource [ Reference(Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Person or organization that provided the information about the consumption of this food or fluid
  fhir:NutritionIntake.derivedFrom [ Reference(Any) ], ... ; # 0..* Additional supporting information
  fhir:NutritionIntake.reasonCode [ CodeableConcept ], ... ; # 0..* Reason for why the food or fluid is /was consumed
  fhir:NutritionIntake.reasonReference [ Reference(Condition|DiagnosticReport|Observation) ], ... ; # 0..* Condition or observation that supports why the food or fluid is /was consumed
  fhir:NutritionIntake.note [ Annotation ], ... ; # 0..* Further information about the consumption
]

Changes since Release 3

This resource did not exist in Release 2

This analysis is available as XML or JSON.

 

See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis a

PathDefinitionTypeReference
NutritionIntake.status A coded concept indicating the current status of a NutritionIntake.RequiredNutritionIntake Status Codes
NutritionIntake.statusReason A coded concept indicating the reason for the status of the statement.ExampleSNOMEDCTDrugTherapyStatusCodes
NutritionIntake.category A coded concept identifying where the medication included in the NutritionIntake is expected to be consumed or administered.PreferredNutritionIntake Category Codes

Tube feedings can be administered via continuous drip using a pump or via intermittent feedings, using gravity drip or a pump. The examples Nutrition Order Enteral Bolus Feeding Example and Nutrition Order Enteral Continuous Feeding Example show how this resource can be used to order both kinds of enteral feeding using the structured data elements. The continuous feeding typically specifies rate of administration and a maximum volume of delivery using the enteralFormula.administration.rate and enteralFormula.maxVolumeToDeliver elements. On the other hand, the intermittent feeding typically specifies the amount and frequency of administration using the enteralFormula.administration.quantity and enteralFormula.schedule elements. In both cases, to vary the rate or quantity over time the enteralFormula.administration element can be repeated.

The examples associated with this resource demonstrate the core elements and do not necessarily reflect real world implementations that may be constrained by future profiles for a given implementation or setting. For example, a renal diet is often comprised of pre-coordinated components including common nutrient modifications such as protein, potassium and phosphorus to assist with the speed of entry of complex diet orders.

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionExpressionIn Common
categorytokenReturns statements of this category of NutritionIntakeNutritionIntake.category
effectivedateDate when patient was taking (or not taking) the medicationNutritionIntake.effective
encounterreferenceReturns statements for a specific encounterNutritionIntake.encounter
(Encounter)
identifiertokenReturn statements with this external identifierNutritionIntake.identifier
nutritiontokenReturn statements of this medication referenceNutritionIntake.consumedItem.nutritionProduct
part-ofreferenceReturns statements that are part of another event.NutritionIntake.partOf
(Observation, Procedure, NutritionIntake)
patientreferenceReturns statements for a specific patient.NutritionIntake.subject.where(resolve() is Patient)
(Patient)
sourcereferenceWho or where the information in the statement came fromNutritionIntake.informationSource
(Practitioner, Organization, Patient, PractitionerRole, RelatedPerson)
statustokenReturn statements that match the given statusNutritionIntake.status
subjectreferenceThe identity of a patient, animal or group to list statements forNutritionIntake.subject
(Group, Patient)